‘Crystal meth’ use among polydrug users in Sydney's dance party subculture: characteristics, use patterns and associated harms

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Abstract

Aims: To examine the characteristics of a small sample of crystal methamphetamine users (‘crystal meth’), and their history of crystal meth and other drug use; to assess the extent and context of crystal meth use; and to document the perceived psychological and physical side effects of use. Method: A sample of 45 persons reporting the use of crystal methamphetamine was recruited from a variety of sources and administered a structured interview regarding their methamphetamine use and related harms. Reports of side effects among this sample of methamphetamine users were compared with those reported by a sample of much heavier, longer-term and predominantly injecting amphetamine powder users, a related but less potent form of this class of drugs. Findings: The sample was largely male, highly educated and employed. Most users had experience with a variety of party drugs, of which crystal methamphetamine was a relatively recent addition. Many users had not had extensive experience with the drug; despite this, high rates of significant physical and psychological side effects were reported. Comparison with amphetamine users revealed that similar proportions of both groups reported most symptoms. Symptoms reflecting high doses of amphetamines (such as chest pains, heart palpitations, panic attacks) were reported by higher proportions of crystal methamphetamine users, whereas amphetamine users were more likely to report violent behaviour, hallucinations, and headaches. Conclusions: Despite relatively recent and infrequent use of crystal methamphetamine, users were highly likely to report a wide range of significant side effects.

Introduction

Amphetamines remain Australia's second most widely used illicit drug after cannabis (Australian Institute of Health and Welfare, 2002). Australia's markets for illicit amphetamines have undergone considerable change in recent years (Topp, Degenhardt, Kaye & Darke, 2002). Traditionally, the form of illicit amphetamine most available was amphetamine sulphate (Chesher, 1993). Following the legislative controls introduced in the early 1990s on the distribution of the main precursor chemicals (Wardlaw, 1993), the pseudoephedrine-to-methamphetamine conversion became the most widely used, and methamphetamine currently dominates the market (Australian Bureau of Criminal Intelligence, 2002).

Chemically, amphetamine and methamphetamine are closely related. Both exert their effects indirectly by stimulating the release of peripheral and central monoamines (principally dopamine, noradrenaline, adrenaline and serotonin) (Seiden, Sobol & Ricaurte, 1993), and both have psychomotor, cardiovascular, anorexogenic and hyperthermic properties. Compared with amphetamine, methamphetamine has proportionally greater central stimulatory effects than peripheral circulatory actions (Chesher, 1993), and is a more potent form with stronger subjective effects. In countries such as Japan, Taiwan, the Phillipines, the Republic of Korea and the United States (US), methamphetamine has been the form of amphetamine most available in recent years, and has been of concern as its availability and use have spread, and associated problems have become more clearly delineated (Farrell, Marsden, Ali & Ling, 2002, Methamphetamine Interagency Task Force, 2000, Shaw, 1999, United Nations Office of Drug Control Policy, 2000).

Australia's strategic early warning system for emergent trends in illicit drug markets, the Illicit Drug Reporting System (IDRS) (Hando, Darke, O'Brien, Maher & Hall, 1998, Topp & McKetin, in press), has documented recent increases in the availability and use of potent forms of methamphetamine. The IDRS findings suggest that there are at least four forms of methamphetamine considered as distinct commodities (Topp et al., 2002). These are: (1) ‘speed’, or methamphetamine powder that is locally manufactured, generally of low purity, and is usually administered by snorting or injecting; (2)‘pills’, which are locally manufactured methamphetamine tablets, often mixed with other drugs such as ketamine, that are sold as ‘ecstasy’; (3) ‘base’ or ‘paste’, which is a gluggy, pasty or oily kind of methamphetamine powder that is locally manufactured and often has a brown or yellow tinge due to the presence of iodine and other organic impurities; and (4) ‘crystal meth’ or ‘ice’, which is high purity, imported crystalline methamphetamine that comes in the form of large, translucent to white crystals that are usually smoked or injected.

This paper focuses on ‘crystal meth’ and its use among polydrug users in Sydney's dance party subculture. The staple drug in the party circuit remains ‘ecstasy’, but polydrug use is the norm among this population (Topp, Hando, Dillon & Solowij, 1999), and the use of crystal meth has increased in recent years (Topp & Darke, 2001; Topp et al., 2002). International experience suggests that crystal meth use is associated with significant harm, most notably psychiatric problems such as methamphetamine-induced psychosis (Farrell et al., 2002; Matsumoto et al., 2002, Yui, Goto, Ikemoto, Nishijima, Yoshina & Ishiguro, 2001), but also physical, relationship, occupational, financial and legal issues (Joe-Laidler & Morgan, 1997, Morgan & Beck, 1997, Pennell, Ellett, Rienick & Grimes, 1999). For some, crystal meth use is closely associated with sexual activity (Morgan & Beck, 1997), and high-risk sexual activity in particular (Semple, Patterson & Grant, 2002).

To investigate the apparent increase in the availability and use of crystal meth in Sydney's party drug markets, a sample of 45 participants recruited for a study of GHB use and overdose (Degenhardt, Darke & Dillon, 2002a, Degenhardt, Darke & Dillon, 2002b) who reported the use of ‘crystal meth’ were administered a brief questionnaire regarding their experience with the drug. Although the external validity of the results obtained from this sample of crystal meth users may be constrained, these data constitute a timely and preliminary investigation of use of crystal meth, and provide the first Australian evidence for the notion that crystalline methamphetamine may be associated with higher levels of harm than amphetamine sulphate.

The aims of this preliminary investigation of crystal meth use were to examine:

  • 1

    The characteristics and drug use patterns of a sample of self-reported crystal meth users;

  • 2

    The context and the perceived benefits and costs of crystal meth use;

  • 3

    The psychological and physical side effects perceived by respondents as associated with their crystal meth use; and;

  • 4

    The similarities and differences of this profile of side effects with those reported by a sample of amphetamine sulphate users recruited in the early 1990s, with the hypothesis that, due to the greater potency of crystal meth, these users may experience a relatively greater degree of harm than users of amphetamine sulphate.

Section snippets

Sample of crystal methamphetamine users

A sample of 76 participants were interviewed (by the first author) for a study of GHB use and associated harms between January and June 2001 (Degenhardt et al., 2002a; Degenhardt et al., 2002b). These participants were volunteers who were paid AU$30 for their participation. They were recruited from advertisements in local newspapers, snowballing, radio interviews, internet bulletin boards, and the AIDS Council of NSW. The sole entry criterion was use of GHB in the preceding 6 months.

Of this

Demographic characteristics of crystal meth users

Eighty two percent of the participants were male, with a mean age of 28.3 years (S.D. 6.5; range 19–45). They had completed a median of 13 years (range 10–13) of school education, and most (82%) had completed further qualifications. Significant proportions of this sample identified as homosexual (58%) or bisexual (16%). The majority (85%) was currently employed, and 4% were students. One participant (2%) had a history of incarceration, and one (2%) was currently in methadone maintenance

Discussion

The data from this sample of self-identified ‘crystal meth’ users provide Australia's first specific investigation of the use and associated harms of this potent form of methamphetamine, the availability and use of which have increased markedly in recent years (Topp et al., 2002).

Acknowledgements

This research was funded by the AIDS Council of New South Wales and the National Drug and Alcohol Research Centre. Thanks to Evelyn Wilhelm, who assisted with data scoring and entry; and to Shane Darke, who provided valuable comments on the manuscript.

References (34)

  • Australian Institute of Health and Welfare (2002). 2001 National Drug Strategy Household Survey: First results....
  • G. Chesher

    Pharmacology of the sympathomimetic psychostimulants

  • S. Darke et al.

    Transitions between routes of administration of regular amphetamine users

    Addiction

    (1994)
  • Degenhardt, L., Darke, S., Dillon, P. (2002b). The prevalence and correlates of GHB overdose among Australian users....
  • Dillon, P., Copeland, J., & Jansen, K. (in press). Patterns of use and harms associated with the non-medical use of...
  • M. Farrell et al.

    Methamphetamine: drug use and psychoses becomes a major public health issue in the Asia Pacific region

    Addiction

    (2002)
  • W. Hall et al.

    Route of administration and adverse effects of amphetamine use among young adults in Sydney, Australia

    Drug and Alcohol Review

    (1994)
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